Should dehydration in older people be a marker of lack of quality in long term care provision?

Lee Hooper (Dietitian and Researcher, NIHR Career Development Fellow and Reader in Research Synthesis and Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK)
Diane K Bunn (Research Nurse and Midwife and Researcher and PhD Student, Norwich Medical School, University of East Anglia, Norwich, UK)

Quality in Ageing and Older Adults

ISSN: 1471-7794

Publication date: 8 December 2014



The purpose of this paper is to consider whether dehydration in older people should be used as a marker of lack of quality in long-term care provision.


The piece examines the assumed relationship between dehydration and the quality of care, and then considers the factors that can lead to dehydration in older people.


Even with the best care, older people, in the absence of a sense of thirst, and for fear of urinary accidents, difficulties getting to the toilet or choking, may choose to drink less than would be ideal for their health. While good care supports older people to minimise these problems, it also respects older people making their own decisions around when, what and how much to drink. It appears that dehydration may sometimes be a sign of good care, as well as arising from poor care.

Social implications

Residential care homes should not be stigmatised on the basis of their residents being dehydrated, but rather helped to explore whether they are achieving an appropriate balance between care and quality of life for their residents.


This discussion may be of use to those living in, working in, managing or assessing residential care.



Thank you to all our generous elderly people who took part in our study on dehydration in care homes (DRIE, Dehydration Recognition In our Elders) and the current qualitative and quantitative research (see This paper results from independent research arising from a Career Development Fellowship to LH (NIHR-CDF-2011-04-025) supported by the National Institute for Health Research. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.


Hooper, L. and Bunn, D.K. (2014), "Should dehydration in older people be a marker of lack of quality in long term care provision?", Quality in Ageing and Older Adults, Vol. 15 No. 4, pp. 232-236.



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